Your Money or Your Life Debt Collection in American Medicine

A riveting exposé of medical debt collection in America — and the profound financial and physical costs eroding patient trust in medicine For the crime of falling sick without wealth, Americans today face lawsuits, wage garnishment, home foreclosure, and even jail time. Yet who really profits from aggressive medical debt collection? And how does this predatory system affect patients and doctors responsible for their care? Your Money or Your Life reveals how medical debt collection became a multibillion-dollar industry and how everyday Americans are made to pay the price. Emergency physician and historian Luke Messac weaves patient stories into a history of law, finance, and medicine to show how debt and debt collection are destroying the foundational trust between doctors and patients at the heart of American healthcare. The fight to stop aggressive collection tactics has brought together people from all corners of the political spectrum. But if we want to better protect the sick from financial ruin, we have to understand how we got here. With wit and clarity, Your Money or Your Life asks us all to rethink the purpose of our modern healthcare system and consider whom it truly serves.

Luke Messac is an emergency physician and historian at Brigham and Women's Hospital and an instructor at Harvard Medical School. His research focuses on the history and political economy of health care. His work has been covered by The New York Times and published in The New England Journal of Medicine, and his first book, No More to Spend, was published by Oxford University Press in 2020.